Fractures of the fifth metatarsal: careful identification for optimal treatment

Fractures of the fifth metatarsal are common in active people. Proximal metaphyseal and distal fractures are usually amenable to conservative treatment, but some proximal fractures, such as Jones, stress, and acute-on-chronic fractures, are often associated with nonunion or delayed union. Such fractures are often best treated by early operative intervention. Correct identification of fifth metatarsal fractures is important because prompt surgical treatment when indicated can shorten recovery and allow a quick return to sports activity. Other causes of lateral foot pain, including accessory ossicles, neuromas, osteoporosis, herniated disks, and osteoid osteoma, should be considered when suspected fractures fail to show up on radiographs.